Parents Served by Assertive Community Treatment: A Needs Based Assessment

Abstract

Assertive Community Treatment (ACT) represents an effective treatment for individuals with severe mental illness. Though studies estimate that as many as half of all people with severe mental illness are parents, little is known about consumers receiving ACT services who are parents. Thus, the purpose of the present study was to 1) estimate the prevalence of parent ACT consumers, 2) identify current ACT team policies and practices for treating parent consumers, and 3) examine the perspective of parent consumers served by ACT teams. Quantitative and qualitative data were collected and analyzed via two separate studies. In study 1, eighty-two ACT providers from 76 teams across the United States and Canada were surveyed to determine the prevalence of parent ACT consumers, ACT team policies for identifying the parental status of consumers, treatment services available for parent consumers, and provider attitudes about parent consumers. Providers estimated roughly 21.6% of ACT consumers were parents. Less than half of providers (46.3%) reported formally asking about parental status during intake and only 20.7% providers belonged to ACT teams that provide special programs/services designed for parent consumers. The majority of providers (75.6%) reported negative or mixed attitudes about parents with severe mental illness. In study 2, seventeen parents with severe mental illness being served by ACT teams were interviewed about parenting, the relationship between parenting and severe mental illness, parenting needs, and suggestions for improved treatment services for parents. All parents were able to identify at least one positive aspect of parenting and most parents (76.5%) also identified negative aspects of parenting. Loss of custody emerged as a significant parenting problem, with the majority of parents (88.2%) experiencing loss of custody at least once. Given the difficulties of being a parent and having to manage a severe mental illness, parents expressed interest in several parent-focused treatment services, including family therapy, parenting skills, communication skills training, resources/finances for children, and social support groups with peers. When asked about overall satisfaction with ACT services, most participants with adult children (87.5%) reported having no unmet parent-related needs and high satisfaction (4.63 out of 5) with ACT services, whereas parents with young children (77.8%) reported having numerous unmet parenting needs and low satisfaction (3.78 out of 5) with ACT services. Thus, the age of participants’ children was a significant factor, indicating that the ACT treatment model may not be adequately serving parents of young, dependent children. Overall, findings suggest the need for more attention and focus on parent consumers, including formal identification of consumers’ parental status and improved parent-related treatment services and support